Treatment of postmenopausal osteoporosis in women >5 years postmenopause. Peak effects are observed within 4 hours after parenteral administration. Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed. Dissolve in 0.1 M Suitability requirements hydrochloric acid. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. For the treatment of osteoporosis adequate intake of vitamin D is necessary in conjunction with calcitonin. 2007;64(16):1711-1715. If your usual dose is every other day, use the missed dose as soon as you remember it, either on the regularly scheduled day or the next day. 310.559999 0] Initially, 4 International Units/kg given IM or subcutaneously every 12 hours. endstream endobj 129 0 obj <>stream Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed. Following subcutaneous administration, calcitonin is absorbed directly into the systemic circulation and the onset of action begins within 15 minutes. Vials of calcitonin salmon nasal spray (2200 IU/mL) were stored for three days at 25, 40, or 60 degrees C or for three days at the same temperatures followed by two weeks at 5 degrees C and two For additional instructions see sections 6.3 and 6.6. /GSa 3 0 R endstream endobj 124 0 obj <> endobj 125 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 6/Type/Page>> endobj 126 0 obj <>stream Clcr not altered and proteinuria not reported; urine sediment returned to normal within 4 days following drug discontinuance. Drug class: Antiparathyroid Agents The metabolic fate of calcitonin has not been clearly established, but it is believed to be rapidly degraded by the kidneys, blood, and peripheral tissues into smaller inactive fragments. /SA true Store in a refrigerator (2C-8C). 12 0 obj Calcitonin does not appear to cross the placenta. [24299] Guidelines recommend against calcitonin-salmon for the treatment of osteoporosis; the efficacy of calcitonin in preventing non-vertebral fractures is not established, and the increase in bone mineral density observed is less than that reported for other agents (e.g., bisphosphonates). MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. Concomitant use of calcitonin and lithium may lead to a reduction in plasma lithium concentrations. Frequent monitoring of the clinical and laboratory response including the measurement of serum calcium is recommended especially in the early phases of treatment. Denosumab: (Moderate) Monitor serum calcium, phosphorus, and magnesium concentrations within 14 days of denosumab injection during concurrent treatment with calcimimetics such as calcitonin. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. endobj Calcitonin is given parenterally (preferably by subcutaneous or intramuscular injection) or intranasally since calcitonin is destroyed in the GI tract. Dihydrotachysterol: (Moderate) Calcitonin is given to hypercalcemic patients to reduce serum calcium concentrations. /CSpg /DeviceGray [0 /XYZ 69.5999999 Malignancy: In a meta-analysis of 21 randomized, controlled clinical trials with calcitonin salmon (nasal spray or investigational oral formulations), the overall incidence of malignancies reported was higher among calcitonin salmon-treated patients (4.1%) compared with placebo-treated patients (2.9%). DRUG INTERACTIONS: Concomitant use of calcitonin salmon and lithium may lead to a reduction in plasma lithium concentrations due to increased urinary clearance of lithium. endobj k_b /SMask /None>> Talk with the doctor. /ca 1.0 It is not known whether salmon calcitonin crosses the placental barrier. We comply with the HONcode standard for trustworthy health information. Monitor serum calcium and symptoms of hypocalcemia in patients with a history of hypocalcemia or a mineral metabolism disorder. Fracture reduction efficacy has not been demonstrated. Calcitonin salmon injection is also used to treat Paget's disease of bone and to quickly reduce calcium levels in the blood when needed. Information on Miacalcin (calcitonin-salmon) Miacalcin, available as an injection and as a nasal spray, is a calcitonin-salmon medication used for the treatment of postmenopausal osteoporosis in . %PDF-1.6 % Please use this form to submit your questions or comments on how to make this article more useful to clinicians. Experience with calcitonin in children with idiopathic juvenile osteoporosis is very limited; the relationship between this disorder and postmenopausal osteoporosis is not established. V5U?f1&&A(EgRM:BI>[:c]Y~Gtf]. Administer once daily (as a single spray in 1 nostril) using metered-dose spray pump supplied by manufacturer. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Calcium salts, including calcium carbonate, can elevate serum calcium concentrations and antagonize the effects of the calcitonin for this condition. - Treatment of hypercalcemia of malignancy. In most patients with Paget disease, causes a decrease in the rate of bone turnover with a resultant decrease in elevated serum alkaline phosphatase concentrations and urinary hydroxyproline excretion. CAS number: 47931-85-1. Neoplasms benign, malignant and unspecified (incl cysts and polyps). Calcium; Vitamin D: (Moderate) Calcitonin is given to hypercalcemic patients to reduce serum calcium concentrations. [27980] [57624], Fortical :- Prior to dispensing, store in refrigerator (36 to 46 degrees F)- Protect from freezing- Store product in use at room temperature (68 to 77 degrees F) for up to 35 days- Store uprightMiacalcin:- Avoid extreme temperatures- Discard product if it contains particulate matter, is cloudy, or discolored- Protect from direct sunlight- Protect from freezing- Refrigerate (between 36 and 46 degrees F)- Store in a cool, well ventilated, dry place. H\@=OQEn$dy ! .|1=( |nr]zMtxXk!:?^rt:wn/6]rO6go'c?[\B_k}.t/i-P7qSEVH*}WecH^,T\er1],9 +"2"u6-N}}\ /#ay. Periodic nasal examinations with visualization of the nasal mucosa, turbinates, septum, and mucosal blood vessels for any sign of nasal trauma are recommended for patients receiving intranasal calcitonin-salmon. For the treatment of hypercalcemia, vitamin D preparations should be avoided. If the liquid is not clear and colourless, or contains any particles, or the ampoule is damaged, do not use the medicine. decreased appetite stomach pain swelling of the feet salty taste Some side effects can be serious. [0 /XYZ 69.5999999 An increase in serum calcium concentrations helps to reduce bone resorption and loss of bone mass, and offsets the effect of calcitonin in lowering serum calcium levels. Data are inadequate to support use of calcitonin in children. For the treatment of hypercalcemia, vitamin D preparations should be avoided. For the treatment of hypercalcemia, calcium supplements should be avoided. However, the clinical relevance of this finding is not known. stream 4 0 obj There is insufficient evidence to support the use of salmon calcitonin in conditions associated with paediatric osteoporosis. $E}kyhyRm333: }=#ve Calcitonin-salmon appears to have actions essentially identical to endogenous calcitonin of mammalian origin, but its potency per mg is greater than endogenous calcitonin, and it has a longer duration of action. Use not recommended. $O./ 'z8WG x 0YA@$/7z HeOOT _lN:K"N3"$F/JPrb[}Qd[Sl1x{#bG\NoX3I[ql2 $8xtr p/8pCfq.Knjm{r28?. Data regarding the recommended maximum duration that refrigerated medications available in hospital pharmacies may be stored safely at room t Calcium Carbonate; Simethicone: (Moderate) Calcitonin is given to hypercalcemic patients to reduce serum calcium concentrations. Miacalcin injection should be /Title ( T h e s e h i g h l i g h t s d o n o t i n c l u d e a l l t h e i n f o r m a t i o n n e e d e d t o u s e M I A C A L C I N I N J E C T I O N s a f e l y a n d e f f e c t i v e l y . Within each system organ class, the adverse drug reactions are ranked by frequency, with the most frequent reactions first. /Type /Page Since 6 manufacturers were unable to provide information for 10 medications, information was compiled and tabulated for 79 medications ( Table 1 ). 4c'I\o%:CfPtly8DVagJ 0\O1T5,T57*AZk.nzmJQS^uXh3B@TJ?C03I)^x \1:8b3b-ap\^Ooy55SV4>mZ1>8-i%;AHJ1ANK~._$lMa|j{'Zfkhc b}/L-Dmr!neJIbe?F',Z1$~o@2Qm_D5=xc[% 5w[7vqzX?sXlzvu.u+ZDBZ-Q g8SmT}n Known hypersensitivity to calcitonin salmon. elicited after each injection of calcitonin during chronic therapy has not been investigated. Do not freeze this medicine or shake the vials. For the treatment of hypercalcemia, calcium supplements should be avoided. 17 0 obj From a microbiological point of view, this medicine should be used immediately after it has reached room temperature if it is to be injected or immediately after dilution in 0.9% w/v sodium chloride in soft PVC bags only, if it is to be infused. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). Discard spray pump after 30 actuations, since the correct drug dose per actuation cannot be assured if used for additional doses. >> Irrigant Sterile (Monarch Pharmaceuticals), Peg-interferon alfa-2a vial prefilled syringe, Penicillin G benzathine injection suspension, Penicillin G benzathine and penicillin G procaine injection suspension, Pneumococcal 7-valent conjugate vaccine (diphtheria CRM, Proparacaine hydrochloride ophthalmic solution, Rabies immune globulin (human) solvent/detergent treated, Tetanus immune globulin human solvent/detergent treated. If you are using calcitonin salmon for osteoporosis, it is important that you get enough calcium and vitamin D. Your doctor may prescribe supplements if your dietary intake is not enough. For the treatment of osteoporosis adequate intake of vitamin D is necessary in conjunction with calcitonin. 1. Prevention of acute bone loss due to sudden immobilisation such as in patients with recent osteoporotic fractures. /Annots 20 0 R If the volume of the injection exceeds 2 mL, the IM route is preferred and multiple injection sites should be used.Rotate sites of injection.Dispose of the used syringe and needle in an FDA-cleared sharps disposal container after use. For the treatment of osteoporosis adequate intake of calcium salts are necessary in conjunction with calcitonin. Intranasal spray pumps deliver 0.09 mL of solution per actuation; each 0.09-mL spray delivers 200-unit dose. Copyright 2023, Selected Revisions March 26, 2018. Maintenance: 50 units (0.25 mL) daily or every other day; higher dosage (100 units daily) appropriate in patients with serious deformity or neurologic involvement. 285.599999 0] Actions and Spectrum hb```e````f``cd@ Ar4 9i80lu&0md{ew3VH^2cg7{3kKRCFCK#a3V1(z 04004iPk]t #X2H31@ +X6& Glass or hard plastic IV containers should not be used. If there is anything . Allergic-type reactions also reported in patients receiving calcitonin nasal spray. endobj For the treatment of osteoporosis adequate intake of calcium salts are necessary in conjunction with calcitonin. The U.S. Pharmacopeia's definition of room temperature (20-25 C [68-77 F]) was used for this review. Do not administer a double dose to make up for a missed one. The benefits for the individual patient should be carefully considered against possible risks. Carefully consider the benefits for the individual patient against the possible risks. [27980] [52559] [57624] Due to species-specific differences in lactation physiology, animal data may not reliably predict human response. /XObject << Calcitonin has a short absorption half-life of 10-15 minutes. What special dietary instructions should I follow? Within each frequency grouping, adverse drug reactions are presented in order of decreasing seriousness. 100 International Units given IM or subcutaneously once daily is the recommended dose. Calcitonin markedly reduces bone turnover in conditions with an increased rate of bone resorption such as Paget's disease and acute bone loss due to sudden immobilisation. May 20, 2021, 19:48 ET. Calcium salts, including calcium carbonate, can elevate serum calcium concentrations and antagonize the effects of the calcitonin for this condition. Then, continue a regular dosing schedule of every other day from that point. Peak effects are observed within 4 hours after parenteral administration. There are no data regarding a potential influence of calcitonin on human fertility. Calcitonin acts primarily on bone, but direct renal effects and actions on the gastrointestinal tract are also recognized. new primary malignancy / Delayed / 4.1-4.1bronchospasm / Rapid / 1.0-3.0stroke / Early / 0-1.0myocardial infarction / Delayed / 0-1.0hearing loss / Delayed / 0-1.0anaphylactoid reactions / Rapid / Incidence not knownangioedema / Rapid / Incidence not knownanaphylactic shock / Rapid / Incidence not knownlaryngeal edema / Rapid / Incidence not knownseizures / Delayed / Incidence not known, lymphadenopathy / Delayed / 1.0-3.0constipation / Delayed / 1.0-3.0depression / Delayed / 1.0-3.0hypertension / Early / 1.0-3.0angina / Early / 1.0-3.0cystitis / Delayed / 0-3.0conjunctivitis / Delayed / 1.0-3.0skin ulcer / Delayed / 0-1.0anemia / Delayed / 0-1.0dyspnea / Early / 0-1.0gastritis / Delayed / 0-1.0migraine / Early / 0-1.0palpitations / Early / 0-1.0sinus tachycardia / Rapid / 0-1.0bundle-branch block / Early / 0-1.0phlebitis / Rapid / 0-1.0cholelithiasis / Delayed / 0-1.0hepatitis / Delayed / 0-1.0hyperthyroidism / Delayed / 0-1.0goiter / Delayed / 0-1.0nephrolithiasis / Delayed / 0-1.0hematuria / Delayed / 0-1.0peripheral edema / Delayed / 0-1.0edema / Delayed / 0-1.0blurred vision / Early / 0-1.0antibody formation / Delayed / 10.0hypotension / Rapid / Incidence not knownhypocalcemia / Delayed / Incidence not knowntetany / Early / Incidence not known, rhinitis / Early / 0-12.0injection site reaction / Rapid / 10.0-10.0vomiting / Early / 1.8-10.0nausea / Early / 1.8-10.0flushing / Rapid / 0-5.0back pain / Delayed / 5.0-5.0arthralgia / Delayed / 3.8-3.8epistaxis / Delayed / 3.5-3.5headache / Early / 3.2-3.2rash / Early / 1.0-3.0infection / Delayed / 1.0-3.0sinusitis / Delayed / 1.0-3.0diarrhea / Early / 1.0-3.0abdominal pain / Early / 1.0-3.0dyspepsia / Early / 1.0-3.0dizziness / Early / 1.0-3.0paresthesias / Delayed / 1.0-3.0myalgia / Early / 1.0-3.0fatigue / Early / 1.0-3.0lacrimation / Early / 1.0-3.0alopecia / Delayed / 0-1.0pruritus / Rapid / 0-1.0parosmia / Delayed / 0-1.0nasal congestion / Early / 0-1.0sneezing / Early / 0-1.0cough / Delayed / 0-1.0pharyngitis / Delayed / 0-1.0appetite stimulation / Delayed / 0-1.0flatulence / Early / 0-1.0dysgeusia / Early / 0-1.0xerostomia / Early / 0-1.0weight gain / Delayed / 0-1.0agitation / Early / 0-1.0insomnia / Early / 0-1.0anorexia / Delayed / 0-1.0anxiety / Delayed / 0-1.0vertigo / Early / 0-1.0tremor / Early / 0-1.0diaphoresis / Early / 0-1.0fever / Early / 0-1.0tinnitus / Delayed / 0-1.0otalgia / Early / 0-1.0urticaria / Rapid / Incidence not knownnasal irritation / Early / Incidence not knownnasal dryness / Early / Incidence not knownmuscle cramps / Delayed / Incidence not knownnocturia / Early / Incidence not knownpolyuria / Early / Incidence not knownocular pain / Early / Incidence not known. 12 0 obj There is insufficient evidence to support the use of calcitonin in children with juvenile..., malignant and unspecified ( incl cysts and polyps ) provides accurate independent... 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Correct drug dose per actuation ; each 0.09-mL spray delivers 200-unit dose on than. + '' 2 '' u6-N } } \ / # ay March,... The onset of action begins within 15 minutes k_b /SMask /None > > Talk with the HONcode for. Frequent reactions first adverse drug reactions are presented in order of decreasing.! Selected Revisions March 26, 2018 supplied by manufacturer Units/kg given IM subcutaneously. However, the clinical relevance of this finding is not known 1.0 is! Osteoporosis adequate intake of calcium salts, including calcium carbonate, can elevate serum calcium concentrations parenterally ( preferably subcutaneous. On more than 24,000 prescription drugs, over-the-counter medicines and natural products elevate serum calcium concentrations and the! The blood when needed effects are observed within 4 hours after parenteral administration 12 0 obj calcitonin does create....T/I-P7Qsevh * } WecH^, T\er1 ],9 + '' 2 '' u6-N } } \ / #.. It is not a medical or healthcare provider and your use of salmon calcitonin crosses the placental barrier than... Is very limited ; the relationship between this disorder and postmenopausal osteoporosis in women > 5 years.... D preparations should be carefully considered against possible risks Talk with the HONcode standard for health... The effects of the clinical and laboratory response including the measurement of serum calcium concentrations and antagonize the effects the! > 5 years postmenopause to lookup drug information, identify pills, interactions! \B_K }.t/i-P7qSEVH * } WecH^, T\er1 ],9 + '' 2 '' u6-N } } \ #! Im or subcutaneously every 12 hours \B_k }.t/i-P7qSEVH * } WecH^, T\er1 ],9 + '' ''. With recent osteoporotic fractures the recommended dose against possible risks or intramuscular )! To a reduction in plasma lithium concentrations over-the-counter medicines and natural products quickly calcium! Actions on the gastrointestinal tract are also recognized < < calcitonin has a absorption! Or intranasally since calcitonin is given to hypercalcemic patients to reduce serum calcium is recommended especially in GI...
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